Healthcare Provider Details

I. General information

NPI: 1477278091
Provider Name (Legal Business Name): TOWERLIGHT HEALTH AND WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2022
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 STEEPLE ST STE 202-37
MASHPEE MA
02649-3287
US

IV. Provider business mailing address

13 STEEPLE ST STE 202-37
MASHPEE MA
02649-3287
US

V. Phone/Fax

Practice location:
  • Phone: 508-375-7936
  • Fax:
Mailing address:
  • Phone: 508-375-7936
  • Fax: 508-213-3892

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. OSHETISI JAMILLAH STANNEY
Title or Position: CEO
Credential: CNP, PMHNP-BC
Phone: 508-375-7936